FINANCING
POPULATION HEALTH
IMPROVEMENT
WORKSHOP SUMMARY
Joe Alper and Alina Baciu, Rapporteurs
Roundtable on Population Health Improvement
Board on Population Health and Public Health Practice
INSTITUTE OF MEDICINE
OF THE NATIONAL ACADEMIES
THE NATIONAL ACADEMIES PRESS
Washington, D.C.
THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001
NOTICE: The workshop that is the subject of this workshop summary was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.
This activity was supported by Contract/Grant No. 245367 between the National Academy of Sciences and The Kresge Foundation. The views presented in this publication do not necessarily reflect the views of the organizations or agencies that provided support for the activity.
International Standard Book Number-13: 978-0-309-30746-8
International Standard Book Number-10: 0-309-30746-5
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Cover credit: “Invest in Me” image used with permission of Joeff Davis, photographer.
Suggested citation: IOM (Institute of Medicine). 2014. Financing population health improvement: Workshop summary. Washington, DC: The National Academies Press.
“Knowing is not enough; we must apply.
Willing is not enough; we must do.”
—Goethe
INSTITUTE OF MEDICINE
OF THE NATIONAL ACADEMIES
Advising the Nation. Improving Health.
THE NATIONAL ACADEMIES
Advisers to the Nation on Science, Engineering, and Medicine
The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Ralph J. Cicerone is president of the National Academy of Sciences.
The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. C. D. Mote, Jr., is president of the National Academy of Engineering.
The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Victor J. Dzau is president of the Institute of Medicine.
The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Ralph J. Cicerone and Dr. C. D. Mote, Jr., are chair and vice chair, respectively, of the National Research Council.
PLANNING COMMITTEE ON RESOURCES FOR POPULATION HEALTH IMPROVEMENT1
TERRY ALLAN (Co-Chair), President, National Association of County and City Health Officials; Health Commissioner, Cuyahoga County Public Health
GEORGE ISHAM (Co-Chair), Senior Advisor, HealthPartners; Senior Fellow, HealthPartners Institute for Education and Research
DEBBIE I. CHANG, Vice President, Policy and Prevention, Nemours
MARY LOU GOEKE, Executive Director, United Way of Santa Cruz County
JIM HESTER, Consultant, Former Director, Health Care Reform Commissioner for the Vermont State Legislature
PEGGY HONORÉ, Director, Public Health System, Finance and Quality Programs, Department of Health and Human Services
JEFFREY LEVI, Executive Director, Trust for America’s Health
GLEN P. MAYS, F. Douglas Scutchfield Endowed Professor of Health Services and Systems, University of Kentucky
JOSÉ MONTERO, Director, New Hampshire Division of Public Health Services
ANDREW WEBBER, Chief Executive Officer, Maine Health Management Coalition
IOM Staff
ALINA BACIU, Senior Program Officer
COLIN FINK, Senior Program Assistant
AMY GELLER, Senior Program Officer
LYLA HERNANDEZ, Senior Program Officer
ANDREW LEMERISE, Research Associate
CAROL MASON SPICER, Associate Program Officer (until March 2014)
DARLA THOMPSON, Associate Program Officer (from May 2014)
ROSE MARIE MARTINEZ, Director, Board on Population Health and Public Health Practice
Consultant
JOE ALPER, Consulting Writer
_________________
1Institute of Medicine planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published workshop summary rests with the workshop rapporteurs and the institution.
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ROUNDTABLE ON POPULATION HEALTH IMPROVEMENT1
GEORGE ISHAM (Co-Chair), Senior Advisor, HealthPartners, Inc.; Senior Fellow, HealthPartners Institute for Education and Research
DAVID KINDIG (Co-Chair), Professor Emeritus, University of Wisconsin School of Medicine and Public Health
TERRY ALLAN, President, National Association of County and City Health Officials; Health Commissioner, Cuyahoga County Board of Health
CATHERINE BAASE, Chief Health Officer, Dow Chemical Company
GILLIAN BARCLAY, Vice President, Aetna Foundation
RAYMOND J. BAXTER, Senior Vice President, Community Benefit, Research and Health Policy; President, Kaiser Foundation International, Kaiser Foundation Health Plan, Inc.
DEBBIE I. CHANG, Vice President, Office of Policy and Prevention, Nemours
GEORGE R. FLORES, Program Manager, The California Endowment
MARY LOU GOEKE, Executive Director, United Way of Santa Cruz County
MARTHE R. GOLD, Professor, Sophie Davis School of Biomedical Education, City College of New York
GARTH GRAHAM, President, Aetna Foundation
PEGGY A. HONORÉ, Director, Public Health System, Finance and Quality Program, Office of the Assistant Secretary for Health, U.S. Department of Health and Human Services
ROBERT HUGHES, President and Chief Executive Officer, Missouri Foundation for Health
ROBERT M. KAPLAN, Director, Office of Behavioral and Social Sciences Research, National Institutes of Health
JAMES KNICKMAN, President and Chief Executive Officer, New York State Health Foundation
PAULA LANTZ, Professor and Chair, Department of Health Policy, George Washington School of Public Health and Health Services
MICHELLE LARKIN, Assistant Vice President, Health Group, Robert Wood Johnson Foundation
THOMAS A. LaVEIST, Professor and Director, Hopkins Center for Health Disparities Solutions, Johns Hopkins University Bloomberg School of Public Health
JEFFREY LEVI, Executive Director, Trust for America’s Health
_________________
1Institute of Medicine forums and roundtables do not issue, review, or approve individual documents. The responsibility for the published workshop summary rests with the workshop rapporteurs and the institution.
SARAH R. LINDE, Rear Admiral, U.S. Public Health Service; Chief Public Health Officer, Health Resources and Services Administration
SANNE MAGNAN, President and Chief Executive Officer, Institute for Clinical Systems Improvement
PHYLLIS W. MEADOWS, Associate Dean for Practice, Office of Public Health Practice, School of Public Health, University of Michigan; Senior Fellow, Health Program, The Kresge Foundation
JUDITH A. MONROE, Director, Office for State, Tribal, Local and Territorial Support, Centers for Disease Control and Prevention
JOSÉ MONTERO, President, Association of State and Territorial Health Officials; Director, New Hampshire Division of Public Health Services
MARY PITTMAN, President and Chief Executive Officer, Public Health Institute
PAMELA RUSSO, Senior Program Officer, Robert Wood Johnson Foundation
LILA J. FINNEY RUTTEN, Associate Scientific Director, Population Health Science Program, Department of Health Sciences Research, Mayo Clinic
BRIAN SAKURADA, Senior Director, Managed Markets and Integrated Health Systems
MARTIN JOSÉ SEPÚLVEDA, Fellow and Vice President, Health Research, IBM Corporation
ANDREW WEBBER, Chief Executive Officer, Maine Health Management Coalition
IOM Staff
ALINA BACIU, Senior Program Officer
COLIN FINK, Senior Program Assistant
AMY GELLER, Senior Program Officer
LYLA HERNANDEZ, Senior Program Officer
ANDREW LEMERISE, Research Associate
CAROL MASON SPICER, Associate Program Officer (until March 2014)
DARLA THOMPSON, Associate Program Officer (from May 2014)
ROSE MARIE MARTINEZ, Director, Board on Population Health and Public Health Practice
Reviewers
This workshop summary has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the National Research Council’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published workshop summary as sound as possible and to ensure that the workshop summary meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the process. We wish to thank the following individuals for their review of this workshop summary:
Janet Corrigan, The Dartmouth Institute for Health Policy and Clinical Practice
Robert Hughes, Missouri Foundation for Health
Glen Mays, University of Kentucky
Paul Stange, Independent Consultant
Although the reviewers listed above have provided many constructive comments and suggestions, they did not see the final draft of the workshop summary before its release. The review of this workshop summary was overseen by George C. Benjamin, American Public Health
Association. Appointed by the Institute of Medicine, he was responsible for making certain that an independent examination of this workshop summary was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this workshop summary rests entirely with the rapporteurs and the institution.
Contents
The Roundtable on Population Health Improvement
2 PAYING FOR POPULATION HEALTH IMPROVEMENT: AN OVERVIEW
3 HEALTH CARE SYSTEM INVESTMENTS IN POPULATION HEALTH IMPROVEMENT
Opportunities, Challenges, and Priorities
Health Care Systems as Partners in the Transformation of Community Health
The Role of Affordable Housing in Population Health
4 COMMUNITY DEVELOPMENT AND POPULATION HEALTH
History, Dimensions, and Opportunities
Lesson from the Reinvestment Fund
Community Development Strategies for Improving Population Health
ACA | Affordable Care Act |
CDFI | community development financial institution |
CMS | Centers for Medicare & Medicaid Services |
EHR | electronic health record |
HEPA | high-efficiency particulate air |
HICCup | Health Initiative Coordinating Council |
HUD | U.S. Department of Housing and Urban Development |
IOM | Institute of Medicine |
IRS | Internal Revenue Service |
OECD | Organisation of Economic Co-operation and Development |
TOD | transit-oriented development |
TRF | The Reinvestment Fund |